Recalling or Fabricating Past Abuse? : Psychotherapy: Michael Yapko says much so-called ‘recovered memory’ is in fact suggested by counselors. Others find merits in their methods.

To psychologist and author Michael Yapko, much of what goes on in the name of psychotherapy is “blatantly stupid.”

First there was Freud’s theory of penis envy, then in the 1970s there were nude encounters and LSD therapy. Today, people delve into past-life regression and turn to crystals for help.

Some of it “is just moronic,” says the San Diego therapist.

But Yapko, an expert in memory and hypnosis, says the therapy most en vogue today goes beyond absurdity. Recalling memories of sexual abuse--either real or imagined--is the latest fad in psychotherapy--and it may be the most dangerous, Yapko warns.

His controversial new book, “Suggestions of Abuse”(Simon & Schuster, $22), is an indictment of mental health professionals who lead their patients to mistakenly believe they are victims of sexual abuse, thus recklessly and unwittingly destroying lives and families.

Yapko, a soft-spoken clinician, has created an uproar among mental health professionals by writing the first book to take the profession to task for its techniques in recovering memory, based on research and surveys of nearly 900 therapists across the country.

Critics who disagree with Yapko’s views say he exaggerates the problem, relies on inconclusive research and may frighten real abuse victims, keeping them from seeking psychological help.

“It’s a very dangerous implication,” contends Lenore Terr, a San Francisco psychologist who writes about recovered memory cases in her recently published book, “Unchained Memories” (Basic Books, HarperCollins, $22).

“There are a lot of people who have extreme anxiety and need psychotherapy. And if they start thinking that evil therapists will get ahold of them and force them into believing things, I think we are going to lose a lot of people who could have been helped,” Terr cautions.

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Public debate over recovered memories has raged in the press and been highlighted in several high-profile court cases, including the lawsuit involving Holly Ramona, an Irvine woman who accused her father of molesting her. The accusations arose while she was under therapy at Western Medical Center-Anaheim.

Yapko’s research sought to determine the level and quality of his colleagues’ expertise in the area of memories and hypnosis.

His conclusion is that some therapists engaging in recovered memory therapy are “frighteningly” misinformed and are suggesting memories of abuse that may never have happened.

“I was surprised and in many cases shocked . . . that so many of my colleagues are conducting their clinical practice on the basis of misinformation and myth,” Yapko said during an interview.

Even before “recovered memories” became the trendy topic of talk shows, Yapko had begun to express dismay over the growing preoccupation therapists had with finding evidence of past abuse.

In the early 1980s, while writing a textbook on the clinical use of hypnosis, Yapko says he would get called about once every three months by a therapist asking that he hypnotize a patient to determine if the patient had been sexually abused as a child.

By the late 1980s, the frequency of such calls from therapists had grown to nearly daily. Concerned, he warned therapists in the revised edition of his textbook about the potential dangers of using hypnosis or other suggestive techniques to unearth buried memories.

He was soon inundated with calls, letters and visits from people all over the country who feared they had been mishandled by a therapist, that their memories of abuse may have been untrue and their lives shattered.

But Yapko says it was one particularly desperate phone call from a woman who wanted him to hypnotize her that really spurred him to write “Suggestions of Abuse.”

“It was the straw that broke the camel’s back,” Yapko recalls. She said she wanted to discover if she had been sexually abused as a child. “What makes you think you might have been abused?” Yapko asked. The woman responded: “Well, I called another therapist for help with my poor self-esteem, and she told me that I must have been abused as a child and I should have hypnosis to find out.”

Yapko was stunned. “I thought, this is crazy,” he says.

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“When I first started talking about this in 1991, (colleagues) were real irritated,” Yapko says. “It was not politically correct to raise any doubts about therapists’ practices in such a sensitive arena like sexual abuse.”

Although the profession is still polarized over the issue of recovered memories, Yapko says increasing numbers of colleagues accept the warning that if not used properly, hypnosis and other techniques may lead patients to adopt false memories.

“What I really want to make clear is that abuse does happen with alarming frequency. . . . This is not about disbelieving or discounting abuse survivors,” Yapko says.

“But under conditions of sloppy therapy, people can be led to believe things that are not true, including that they were abused.”

Yapko says he wrote the book to both educate and alert the public and help families who have become entangled in these cases.

Allegations based on supposed repressed memories have reached epidemic proportions in this country, he says.

In surveys presented to therapists at psychotherapy conventions, he questioned professionals about their knowledge and practice of recovering memories and hypnosis. He surveyed those at therapy training courses he taught. He also viewed videotapes of therapists’ sessions with patients.

The recovered memory theory holds that people who may have suffered a traumatic experience such as sexual abuse may repress or psychologically block out the memory because it is too painful. At a later time, the memory may surface on its own or be recovered with the help of hypnosis, counseling or drug therapy, according to some professionals.

Yapko doesn’t deny that some people may repress terrible memories. But he and others admit that there is no way to know if a reclaimed memory is true unless there is corroborating evidence.

James L. McGaugh, director of UCI’s Center for the Neurobiology of Learning and Memory, is a scientist who has done research in the field of memory since 1956. He says the recovered memory movement among some therapists is “absolutely irresponsible.”

McGaugh insists there is no scientific evidence to prove that so-called recovered memories are accurate.

The number of cases in which people are claiming to have sudden memories of terrible experiences in their past is astonishing, he says. There is an entire “cottage industry” that has grown up around this kind of therapy.

He says people are willing to embrace the therapy because they want some kind of explanation for why they have problems.

Tustin lawyer Brandt Caudill, who often defends therapists in lawsuits stemming from repressed memory cases, says there has been a dramatic upswing in lawsuits filed against therapists by patients who contend they were wronged during therapy.

The recent verdict in the Ramona case had a significant impact on the public, Caudill says. In May, a Napa Valley Superior Court jury awarded Gary Ramona $500,000, ruling that his daughter’s therapists had wronged him by implanting false memories of child abuse during her therapy.

Caudill said his office alone has about two dozen cases pending in California courts.

The American Psychiatric Assn.’s Board of Trustees issued a statement in December expressing concern that “the public confusion and dismay over this issue and the possibility of false accusations not discredit the reports of patients who have indeed been traumatized by actual previous abuse.”

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Yapko’s concern lies with how patients’ memories are being recalled and what role therapists and other outside influences may have played in forming that memory.

Did the patient remember the memory independently? Or did a therapist draw it out under hypnosis, under the influence of the drug sodium Amytal or during suggestive questioning? Was it in a dream? Or could the memory be an image once seen in a movie or read in a book?

The therapists’ responses to his survey “indicate grave cause for concern,” Yapko says.

“While the great majority of therapists are well-intentioned people who genuinely want to help their clients, the survey data make it abundantly clear that too many therapists hold beliefs that are sometimes arbitrary, sometimes sheer myth, and sometimes outright dangerous to their clients’ well-being,” Yapko writes in the book.

Of the 864 therapists who responded to one portion of the survey, 57% admitted “that they do nothing at all to differentiate truth from fiction” when dealing with patients’ memories, Yapko writes.

Forty-three percent of the therapists who participated in the survey believed that “if someone doesn’t remember much about his or her childhood, it is most likely because it was somehow traumatic,” he reports.

Although research on hypnosis as an effective investigative method shows conflicting results, nearly half believe that memories obtained under hypnosis are more accurate than simply remembering, Yapko says.

Hypnosis is “not a lie detector, nor does it prevent either intentional or unintentional deception on the part of the hypnotized person,” Yapko writes. Yet one in five of the therapists questioned said they believed that people cannot lie under hypnosis.

Yapko said he was heartened to find that 75% believed it is possible to “suggest false memories to someone who then incorporates them as true memories.” Nearly one in five therapists said they could point to cases where it seemed likely that a victim’s trauma was somehow suggested by the therapist rather than a real experience.

Terr, an author and clinical professor of psychiatry at UC San Francisco, disagrees with Yapko over the frequency of patients being mishandled by therapists.

“I think he overstates the problem,” Terr said in an interview.

She is an expert on trauma and memory and is known for her research on the kidnaped children of Chowchilla. She was an expert witness for the prosecution in the 1991 murder conviction of George Franklin in Redwood City. Franklin was found guilty based on his daughter’s testimony that, after 20 years, she suddenly remembered seeing her father murder her childhood friend. Terr also testified on the behalf of the therapists sued in the Gary Ramona case.

Terr, who has faced off against Yapko on the talk show circuit, says it is rare for recovered memories to be wholly false. She also disagrees with Yapko’s view that many mental health professionals are so misinformed about memory that they are planting memories in their patients’ minds.

Most therapists are well-intentioned and treat people properly, she said.

“Obviously, it sometimes happens. . . . There are a few rotten eggs in any basket. . . . But he has numbers that I really would find mind-boggling.

“I think the number of people who are having true return of memory are much greater than the number of people who are having implanted memories by someone else,” Terr says.

But Yapko contends the risk of patients’ true memories being contaminated or false memories being suggested is very real.

In his book, he cites examples of some of the comments and questioning techniques used by therapists that he believes can carelessly lead patients to develop false memories of abuse.

Despite the lack of evidence to suspect the patient was abused, according to Yapko, a therapist might say, “Your symptoms seem to fit the profile of someone who was sexually abused as a child. Were you?”

Another approach may be, “I have reason to believe you were sexually abused as a child. Can you think of any experiences you might have had that would be considered evidence of abuse?”

These types of statements and questions can lead to confusion and distress and potentially taint real memories with sexual connotations, Yapko argues. After hearing these remarks, the patient is forced to consider the possibility that he may have been abused, even if he never had any reason to believe so. Sometimes allegations of satanic ritual abuse and evidence in these cases sound very far-fetched to observers, said attorney Caudill. “But look at the Jeffrey Dahmer case, the Branch Davidians or the Jim Jones case. These cases were very outlandish.” No one would have believed such events could have happened, he said.

The notion of going to a therapist seeking help for a specific problem and having them suggest--without any corroborating evidence--that you may have been sexually abused as a child is frightening, said Yapko.

He advises adults and parents of young children who are going to therapy to be wary of mental health professionals who jump to conclusions and offer snap opinions on whether the patient fits a profile of an abuse victim.

“That is a legitimate concern,” Yapko said. “There are paranoid therapists. There are therapists who are intent on finding abuse with no matter what someone comes in for, including acne.”